Inspection on 18/10/06 for Abbeyfield Greensted

This inspection was carried out on 18th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Abbeyfield Greensted 17/10/08

Abbeyfield Greensted 21/11/05

Abbeyfield Greensted 20/06/05

Abbeyfield Greensted 11/11/04

Abbeyfield Greensted 01/06/04

Similar services:

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Wingham Court

Old Hastings House

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Abbeyfield Greensted 16 The Orpines Wateringbury Maidstone Kent ME18 5BP Lead Inspector Alison Spreadbridge Key Unannounced Inspection 18th October 2006 16:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Abbeyfield Greensted Address 16 The Orpines Wateringbury Maidstone Kent ME18 5BP 01622 813106 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) The Abbeyfield Kent Society Mrs Lorraine Edith Cousins Care Home 39 Category(ies) of Old age, not falling within any other category registration, with number (39) of places Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Rooms 37, 38 and 39 are not suitable for wheelchair users. Care of one Service User is restricted to one person whose date of birth is 24/09/1942. Respite care of not more than 4 weeks for any one stay for one service user is restricted to one person whose date of birth is 29/11/43. 21st November 2005 Date of last inspection Brief Description of the Service: Greensted is situated in a quiet residential area within walking distance of a local shop and approximately 15 minutes drive to the town of Maidstone. The home has a large dining room and several sitting rooms throughout. One area of the home on the upper floor has been turned into a relaxation area complete with an automated massage chair and a music centre. The home has a wellmaintained library with some large print books. There is also access to talking books and tapes. The gardens are attractive and well maintained with seating areas. The current fees range from £353.18 - £450.00 per week Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced visit was carried out at 4pm on the 18th October 2006. The visit was made as part of the regular inspection programme. The home and staff offer visitors a very warm welcome. This was confirmed when speaking with relatives who were visiting the home at the time of the inspection as well as staff and service users. The service provided for the service users is very good, however the daily record keeping and correlation between information in the care plans and risk assessments lets the home down. The evidence seen suggests more training is required in this area. The inspection reports can be obtained from the home by speaking with the home’s manager or administrator. What the service does well: What has improved since the last inspection? Some of the corridors have been decorated and work is being done to brighten up the hallways. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3,4,5,6 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to make an informed choice about moving into the home. EVIDENCE: The prospective service users are provided with they information they need to make an informed choice about moving into the home. Each service user is provided with a contract and written agreement which outlines their rights and responsibilities. Staff are made aware of this as part of their induction into the home. The manager said that she, or the deputy manager arrange to go out and visit prospective service users to ensure their needs are fully assessed before coming into the home. The relatives spoken with during the inspection said that they were made very welcome from the moment they came to the home. Staff are very friendly and helpful and they feel able to speak to any of the staff if they were concerned. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 9 The service is able to offer some respite care and has an arrangement for six people with Parkinson’s Disease to come into the home for respite care. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11 Quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home must ensure that all medications given to service users are recorded and that care records are completed and maintained up to date. EVIDENCE: The service users are registered with the local doctors surgery if they are unable to continue to remain with their own local GP. The doctor makes regular calls to the home and will see any of his patients who are unwell. The optician and dentist call into the home annually if service users cannot go out. They also call at other times by arrangement. The service users are able to self medicate if they ask to and a suitable risk assessment is undertaken to ensure the service users’ safety. The storage and administration of medication was inspected and a number of errors were found where staff had not signed for the medication. The home’s medication policy states that staff should administer medication and then it should be signed for immediately. This matter was discussed with the manager during the inspection. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 11 The service users said they found all of the staff cheerful and very easy to talk to. They said they are always treated with respect and given the name they like to be called by. There is a part in the service user’s care plan which deals with their spirituality and final wishes following death. The form was not always fully completed. The service users care plans contain the required information however the daily recording does not reflect the whole of the service user’s life in the home. The daily records offer evidence of mostly food and drink consumed and vague references to the personal care given. A number of the care plans were seen and found to contain limited information about the service users daily life. Staff are required to record professional visits and activities on separate sheets but they are not cross-referenced with the daily log. The need to be able to audit the care being given to service users was discussed with the manager. The service users were keen to talk about the outing they had to the coast in the summer. The manager said they try to arrange at least four outings a year. This usually includes the ‘Christmas pantomime and a tour of the Christmas lights’. Bingo, musical entertainers and the dog patting service are regular occurrences. The service users also said they enjoyed some of the arts and crafts sessions the activity co-ordinators arrange. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users were happy with their life in the home but would like an increase and more choice in activities. EVIDENCE: The service users spoken with said that their experience of living in the home is very good and that staff are kind and helpful. This was confirmed by some of the service users’ relatives. They said they enjoyed the activities but would like more choice. Some of the people spoken with were able to tell the inspector when and what day each event took place. It was clear from what was said that the activities have not been changed for some time. The service users’ family and friends are encouraged to visit the home when they want to and service users have the use of a payphone if they wish to phone family and friends. The pay phone is poorly sited in a corridor on the ground floor. The service users spoken with said that residents’ meetings were held at irregular intervals but that if they had concerns they would be able to explain their feelings and that they were listened to. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 13 The Menus are taken round to the service users each day and they are able to make their choices for the next days meals. The service users said they had a nice choice of food and that the portions were right but you could always ask for a second helping if you wanted to. The day’s menus were written on a board outside of the dining room as a reminder of the choices available. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,17,18 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users said they were confidant staff would investigate any concerns or complaints quickly. EVIDENCE: Service users and their families were aware of the home’s complaints procedure. They said they felt able to take any concerns to the manager or a member of staff and they would deal with it quickly. Staff spoken with were aware of the home’s complaints procedure and had read the policies and procedures as part of their induction to working in the home. The home has policies and procedures in place which protect the service user. The home operates an ‘open door’ policy and encourages service users and their families to voice their concerns A recent adult protection meeting was raised by the home to ensure the care they had provided for a service user was considered appropriate. Some areas for improvement were identified which will improve the home’s procedures and record keeping. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 119, 20, 21, 22, 23,24,25,26 Quality of this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users have a warm comfortable home but it is in need of some refurbishment. EVIDENCE: The home while clean and tidy is beginning to show signs of wear and tear. The corridor carpets throughout the home are in need of replacement. The home has a full time maintenance person who is currently painting the corridors to help brighten the environment for service users. One corridor has an odour problem, which the manager is aware of and is seeking to remedy. The gardens and lawn areas are well kept. The outside woodwork and soffits are in need of attention, the paint and wood is peeling and looks quite neglected. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 16 Maintenance certificates were seen to be in date with the home’s public liability insurance and registration certificates on show. The home’s kitchen staff have just won the silver Environmental Award. The service users spoken with were in the main happy with their rooms and the personal items they had been able to bring with them. One new service user said her room was nice and bright and she had settled into her new surroundings well. One service user did express the wish to have a bigger room which the manager agreed to talk to her about as one of the larger rooms might soon become available as it is currently used for respite care. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users benefit from a very dedicated staff team. As a form of development the team should have further training in the care of service users in the end days. There are times when the number of staff on duty needs to reflect the changing needs of service users. EVIDENCE: The policies and procedures are in place to ensure staff are trained and competent to meet the needs of service users. Staff training is ongoing and reflects the category of service users living in the home. On discussion with the manager times were identified when the number of staff on duty did not meet the assed needs of service users. The needs to ensure staff are able to meet service users needs especially during the last days of a service user’s life was discussed. Staff must ensure that when meeting service users’ personal care they ensure that toilet doors are closed and privacy is maintained. Some of the staff recruitment files were seen during the inspection. It was noted that in one file a reference was written ‘to whom it may concern’ good practice dictated that references should be written to a named person within the organisation. One of the files did not have a CRB disclosure in it and there Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 18 was no number to identify that the actual CRB had been shredded. All of the other required information was present in the files. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32,33,34,35,36,37,38 Quality of this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users benefit from living in a well managed home. EVIDENCE: One of the strengths of the home is that it is run and managed by a wellmotivated manager and staff team. The manager and deputy manager both have the Registered Managers Award and traing to level NVQ 4 in care. The home is being run in the best interest of service users. The manager and Abbeyfields are committed to ensuring staff are able to attend staff meetings and receive regular supervision and support from senior staff. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 20 The home’s care plans are in need of review to ensure they truly reflect the life of people living in the home and they reflect the care staff provide and are more that separate snap shots of individual diets and activities a more reflect the actual life the service users are enjoying. Weight charts and water low scales need to be completed regularly especially for those service users in their end days. At present the care plans and risk assessments do not evidence the care provided by staff. Service users who require the use of cot sides is well documented and professional and family consultations take place before they are put into use. The home’s policies and procedures for the use of special mattresses and the consultation process is unclear and needs to be reviewed to ensure they are made available in good time. It was noted during the inspection that some of the outside doors were left open and the areas unattended which could present a risk to service users’ personal possessions. If staff are leaving an area they should secure the outside doors. Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 2 3 3 3 3 3 3 2 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 3 X 3 2 3 Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 schedule 3 Requirement Timescale for action 30/12/06 2. OP8 14 (2) The registered person must ensure that the daily recording of service users care must reflect the assessed needs of service users and be updated as service users needs change. The provider must ensure that 30/12/06 service users care plans are kept under review and that reflect the changing needs of service users. The home ensures that treatment advised is documented and followed up via the daily reporting notes. The registered person must ensure all medication is administered as per the home’s policies and signed for at the time of administration. The registered person must ensure that the home is maintained to a good standard. The carpets in the hallways are in need of replacement and the outside of the house needs attention. The registered person must ensure the home remains free of DS0000023944.V312211.R01.S.doc 3. OP9 13 (2) 30/12/06 4. OP9 23 ( 1) 30/03/07 5. OP26 16 2 ( k) 30/12/06 Abbeyfield Greensted Version 5.2 Page 23 6. OP37 17 offensive odours. The registered person must ensure records are completed up to the end of life. 30/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Abbeyfield Greensted DS0000023944.V312211.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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